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When Is Depression Crippling?

Everyone gets depressed occasionally. It is a normal part of life. Looking forward to something that does not return desired results can lead to mood changes, weight fluctuation, loss of sleep. In most cases, the symptoms are temporary. But if they drag on for weeks, they can be crippling.


A person suffering from clinical depression, sometimes also called major depressive disorder, must either experience a lack of interest or joy in daily activities or depressed mood regularly for two weeks. Such depression when observed usually denotes a substantial difference from what would be considered the person’s usual daily mood. Mood shifts can harm how a person functions at school, work, or at home, but the symptoms can often be treated with medications like ketamine.


Mental health professionals use the same criteria when diagnosing mental illness. That criteria is spelled out in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association.

A person suffering from a mental illness may be diagnosed when five or more of the following, including depressed mood or loss of interest or pleasure, are present for two weeks:

  • Depressed most of the day, nearly every day as indicated by subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful)
  • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by subjective account or observation)
  • Significant weight loss when not dieting or weight gain (e.g., change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day
  • Insomnia or hypersomnia nearly every day
  • Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
  • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide”


According to most mental healthcare professionals, depression becomes crippling for different people at different times, based on many factors. But the one thing most agree on is this: Depression is crippling when it begins restricting basic functioning, such as going to work and living normally. Some people with depression have episodes that persist for a few weeks or months. For others, depression is a crippling ailment when it resists treatment and becomes a lifelong struggle.


The number of people suffering from depression is unknown, mostly because it is a mental health condition that goes unreported and untreated for many reasons – embarrassment, lack of healthcare, the belief that it will “just go away.” The number of U.S. adults affected by depression could be 15 million annually.


Diagnosis of crippling depression follows a standard pattern. First, a medical doctor will perform a physical, ask about your medical history, and run tests that may rule out a condition that causes the depression. Second, or instead of a physical, a mental health provider will perform a psychological exam that focuses on emotions, moods, and behavior. Finally, the results of one or both exams will be compared to criteria in the DSM-5 for final diagnosis.


There are many ways to treat depression, which you and your doctor or therapist will talk about and decide on. Options include psychotherapy, electroconvulsive therapy, self-help, medication, and in some cases hospitalization. In-patient therapy will occur regularly, often spanning the course of several months or longer to help manage symptoms.


In many cases, a doctor or mental healthcare provider will prescribe anti-depressants to be used in conjunction with some form of therapy. Over the last several years, government and private research has looked into the efficacy of drugs like ketamine, which improve neurotransmitter function in the brain, to ease symptoms of depression. Ketamine, or esketamine, is dispensed via infusion therapy or a nasal spray. It was originally used as an anesthetic during the Vietnam war.


If you or a loved one is depressed, seek care immediately and do not wait until the symptoms become crippling. A medical doctor or mental health provider will work with you to design a treatment program, possibly including psychotherapy or drugs like ketamine.
If you or a loved one have questions about the clinical use of ketamine we can help. Ketamine has been shown to provide rapid relief from the symptoms of depression where other medications have failed. Contact us today.